Generic name: methylphenidate (oral) (METH il FEN i date)
Brand name: Ritalin tablets, Ritalin LA capsules
Drug class: CNS stimulants
Ritalin (methylphenidate) is a central nervous system stimulant. It affects chemicals in the brain and nerves that contribute to hyperactivity and impulse control.
Ritalin is used to treat attention deficit disorder (ADD), attention deficit hyperactivity disorder (ADHD), and narcolepsy.
Ritalin should be used as a part of a total treatment program for ADHD that may include counseling or other therapies.
Warnings
You should not use Ritalin if you have glaucoma, tics or Tourette's syndrome, or severe anxiety, tension, or agitation.
Methylphenidate may be habit-forming. Misuse can cause addiction, overdose, or death. Tell your doctor if you have had problems with drug or alcohol abuse.
Stimulants have caused stroke, heart attack, and sudden death in people with high blood pressure, heart disease, or a heart defect.
Do not use Ritalin if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.
Methylphenidate may cause new or worsening psychosis (unusual thoughts or behavior), especially if you have a history of depression, mental illness, or bipolar disorder.
You may have blood circulation problems that can cause numbness, pain, or discoloration in your fingers or toes.
Call your doctor right away if you have: signs of heart problems - chest pain, feeling light-headed or short of breath; signs of psychosis - paranoia, aggression, new behavior problems, seeing or hearing things that are not real; signs of circulation problems - unexplained wounds on your fingers or toes.
Before taking this medicine
Do not use Ritalin if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, tranylcypromine, and others.
You may not be able to use Ritalin if you are allergic to methylphenidate, or if you have:
- glaucoma;
- a personal or family history of tics (muscle twitches) or Tourette's syndrome; or
- severe anxiety, tension, or agitation (stimulant medicine can make these symptoms worse).
Stimulants have caused stroke, heart attack, and sudden death in certain people. Tell your doctor if you have:
- heart problems or a congenital heart defect;
- high blood pressure; or
- a family history of heart disease or sudden death.
To make sure Ritalin is safe for you, tell your doctor if you or anyone in your family has ever had:
- depression, mental illness, bipolar disorder, psychosis, or suicidal thoughts or actions;
- motor tics (muscle twitches) or Tourette's syndrome;
- blood circulation problems in the hands or feet;
- seizures or epilepsy;
- problems with the esophagus, stomach, or intestines;
- an abnormal brain wave test (EEG); or
- drug or alcohol addiction.
Tell your doctor if you are pregnant or breastfeeding.
Ritalin is not approved for use by anyone younger than 6 years old. Ritalin LA is approved for patients from 6 to 12 years of age.
How should I take Ritalin?
Take Ritalin exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose.
Your dose needs may change if you switch to a different brand, strength, or form of methylphenidate. Avoid medication errors by using only the medicine your doctor prescribes.
Methylphenidate may be habit-forming. Misuse can cause addiction, overdose, or death. Never share this medicine with another person. Keep the medicine where others cannot get to it. Selling or giving away Ritalin is against the law.
To prevent sleep problems, take this medicine in the morning.
Take immediate release (IR) Ritalin tablets 30 to 45 minutes before a meal.
Swallow the extended-release Ritalin LA capsule whole and do not crush, chew, or break open the capsule.
If you cannot swallow a capsule whole, open it and mix the medicine with pudding or applesauce. Swallow the mixture right away without chewing.
Tell your doctor if you have a planned surgery.
Your doctor will need to check your progress on a regular basis. Tell any doctor who treats you that you are using Ritalin.
Store at room temperature away from moisture and heat.
Keep your medicine in a place where no one can use it improperly.
Dosing information
Usual Adult Dose for Attention Deficit Disorder:
IMMEDIATE-RELEASE (IR): Average dose: 20 to 30 mg orally in 2 or 3 divided doses, preferably 30 to 45 minutes before meals
Maximum dose: 60 mg/day.
EXTENDED-RELEASE (ER): 8-hour ER oral tablet (e.g., Ritalin SR) - May be used when titrated 8-hour IR dose corresponds to available 8-hour ER tablet; available as 20 mg tablets; Maximum dose: 60 mg/day
Usual Adult Dose for Narcolepsy:
IMMEDIATE-RELEASE (IR): Average dose: 20 to 30 mg orally in 2 or 3 divided doses, preferably 30 to 45 minutes before meals
Maximum dose: 60 mg/day.
EXTENDED-RELEASE (ER): 8-hour ER oral tablet (e.g., Ritalin SR) - May be used when titrated 8-hour IR dose corresponds to available 8-hour ER tablet; available as 20 mg tablets; Maximum dose: 60 mg/day.
Usual Pediatric Dose for Attention Deficit Disorder:
6 years or older:
IMMEDIATE-RELEASE (IR):Initial dose: 5 mg orally twice a day (before breakfast and lunch)
-Increase dose gradually in increments of 5 to 10 mg per week; individualize dose according to needs and response of patient
Maximum dose: 60 mg/day
EXTENDED-RELEASE (ER): 8-hour ER oral tablet (e.g., Ritalin SR): -May be used when titrated 8-hour IR dose corresponds to available 8-hour ER tablet; available as 20 mg tablets; Maximum dose: 60 mg/day
Once daily (50% IR/50% ER) oral capsule (e.g., Ritalin LA):
Age: 6 to 12 years of age (methylphenidate-naive):
-Initial Dose: 20 mg orally once a day in the morning; may initiate at 10 mg orally once a day when a lower dose is appropriate
Patients Currently Using Immediate-release (IR) or Sustained-release (SR) Methylphenidate:
-Initial dose: 10 mg orally once a day if current IR dose is 5 mg twice a day
-Initial dose: 20 mg orally once a day if current IR dose is 10 mg 2 times a day or SR dose is 20 mg once a day
-Initial dose: 30 mg orally once a day if current IR dose is 15 mg 2 times a day
-Initial dose: 40 mg orally once a day if current IR dose is 20 mg 2 times a day or SR dose 40 mg once a day
-Initial dose: 60 mg orally once a day if current IR dose is 30 mg 2 times a day or SR dose 60 mg once a day
TITRATE gradually in 10 mg increments weekly to optimal response
Maximum dose: 60 mg/day.
Comments: - All methylphenidate products are FDA approved for pediatric patients 6 years or older with 1 exception; The once daily 50% IR/50% ER oral capsules (Ritalin LA) are approved for patients 6 to 12 years of age only.
Usual Pediatric Dose for Narcolepsy:
6 years or older:
IMMEDIATE-RELEASE (IR): Initial dose: 5 mg orally twice a day (before breakfast and lunch)
-Increase dose gradually in increments of 5 to 10 mg per week; individualize dose according to needs and response of patient
Maximum dose: 60 mg/day.
EXTENDED-RELEASE (ER): 8-hour ER oral tablet (e.g., Ritalin SR): -May be used when titrated 8-hour IR dose corresponds to available 8-hour ER tablet; available as 20 mg tablets; Maximum dose: 60 mg/day.
What happens if I miss a dose?
Use the medicine as soon as you can, but skip the missed dose if it is later than 6:00 p.m. Do not use two doses at one time.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of methylphenidate could be fatal.
What should I avoid while taking Ritalin?
Avoid drinking alcohol.
Avoid driving or hazardous activity until you know how Ritalin will affect you. Your reactions could be impaired.
Ritalin side effects
Get emergency medical help if you have signs of an allergic reaction to Ritalin: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- signs of heart problems - chest pain, trouble breathing, feeling like you might pass out;
- signs of psychosis - hallucinations (seeing or hearing things that are not real), new behavior problems, aggression, hostility, paranoia;
- signs of circulation problems - numbness, pain, cold feeling, unexplained wounds, or skin color changes (pale, red, or blue appearance) in your fingers or toes; or
- penis erection that is painful or lasts 4 hours or longer (rare).
Methylphenidate can affect growth in children. Tell your doctor if your child is not growing at a normal rate.
Common Ritalin side effects may include:
- excessive sweating;
- mood changes, feeling nervous or irritable, sleep problems (insomnia);
- fast heart rate, pounding heartbeats or fluttering in your chest, increased blood pressure;
- loss of appetite, weight loss;
- dry mouth, nausea, stomach pain; or
- headache.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
What other drugs will affect Ritalin?
Other drugs may interact with methylphenidate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.